Abstract
BACKGROUND: The objectives of this review and meta-analysis were twofold: first, to critically evaluate the effectiveness of cognitive behavioral therapy (CBT)-based interventions relative to standard care or control conditions in promoting smoking abstinence at the end of treatment, and second, to determine abstinence rates at 3 and 6 months of follow-up. METHODS: A comprehensive search of electronic databases, including PubMed, Cochrane Library, PsycINFO, Embase, and ClinicalTrials.gov, was conducted for randomized controlled trials published from 2001 to September 2024. Studies evaluating the effect of CBT on abstinence rates among healthy smokers (aged ≥12 years) were included and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Out of 1,514 study records screened, 7 studies (comprising 17 arms and 1,438 participants) met eligibility criteria for inclusion in the final analysis. The pooled analysis revealed that CBT significantly improved smoking abstinence rates, demonstrating a fourfold increase in effectiveness compared to controls (odds ratio [OR], 4.04; 95% confidence interval [CI], 2.73-5.99; I2=19%; p<0.00001). Additionally, CBT significantly impacted smoking cessation at 3-month follow-up (OR, 1.62; 95% CI, 1.11-2.38; I2=0%; p=0.01) and 6-month follow-up (OR, 2.19; 95% CI, 1.59-3.00; I2=0%; p<0.00001). CONCLUSION: CBT has demonstrated efficacy in facilitating smoking abstinence, particularly immediately after treatment, with sustained but diminished effects over time. However, robust conclusions on the efficacy of CBT require further studies involving larger sample sizes, diverse geographical regions, and longer follow-up periods.